Skip to main content

Advertisement

SpringerLink
Log in

Treatment of Attention-Deficit/Hyperactivity Disorder with Medication in Children with Autism Spectrum Disorder With and Without Intellectual Disability: A DBPNet Study

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Children with autism spectrum disorder (ASD) and intellectual disability (ID)/global delay (GD) frequently have symptoms of attention-deficit/hyperactivity disorder (ADHD). We describe the practice patterns of developmental behavioral pediatricians (DBPs) in the treatment of children with ASD and coexisting ADHD and compare medication classes for children with and without intellectual disability. In bivariate analyses, we compared demographic characteristics, co-occurring conditions, and medication classes for children with and without intellectual disability. Significantly more patients with ID/GD were prescribed α-agonists than patients without ID/GD, but the difference was no longer significant when controlling for age in logistic regression children with ID/GD had more comorbidities and were more likely to be prescribed more than on psychotropic medication. In conclusion, age rather than ID/GD was associated with medication choice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aman, M. G., Buican, B., & Arnold, L. E. (2003). Methylphenidate treatment in children with borderline IQ and mental retardation: Analysis of three aggregated studies. Journal of Child and Adolescent Psychopharmacology, 13(1), 29–40.

    Article  PubMed  Google Scholar 

  • Aman, M. G., Kern, R. A., McGhee, D. E., & Arnold, L. E. (1993). Fenfluramine and methylphenidate in children with mental retardation and ADHD: Clinical and side effects. Journal of the American Academy of Child and Adolescent Psychiatry, 32(4), 851–859.

    Article  PubMed  Google Scholar 

  • Aman, M. G., Marks, R. E., Turbott, S. H., Wilsher, C. P., & Merry, S. N. (1991). Clinical effects of methylphenidate and thioridazine in intellectually subaverage children. Journal of the American Academy of Child and Adolescent Psychiatry, 30(2), 246–256.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. American Psychiatric Association.

    Book  Google Scholar 

  • Barbaresi, W. J., Campbell, L., Diekroger, E. A., Froehlich, T. E., Liu, Y. H., O’Malley, E., Pelham, W. E., Jr., Power, T. J., Zinner, S. H., & Chan, E. (2020a). Society for developmental and behavioral pediatrics clinical practice guideline for the assessment and treatment of children and adolescents with complex attention-deficit/hyperactivity disorder. Journal of Developmental and Behavioral Pediatrics, 41(Suppl 2S), S35–S57.

    Article  PubMed  Google Scholar 

  • Barbaresi, W. J., Campbell, L., Diekroger, E. A., Froehlich, T. E., Liu, Y. H., O’Malley, E., Pelham, W. E., Jr., Power, T. J., Zinner, S. H., & Chan, E. (2020b). The society for developmental and behavioral pediatrics clinical practice guideline for the assessment and treatment of children and adolescents with complex attention-deficit/hyperactivity disorder: Process of care algorithms. Journal of Developmental and Behavioral Pediatrics, 41(Suppl 2S), S58–S74.

    Article  PubMed  Google Scholar 

  • Blum, N. J., Shults, J., Harstad, E., Wiley, S., Augustyn, M., Meinzen-Derr, J. K., Wolraich, M. L., & Barbaresi, W. J. (2018). Common use of stimulants and alpha-2 agonists to treat preschool attention-deficit hyperactivity disorder: A DBPNet study. Journal of Developmental and Behavioral Pediatrics, 39(7), 531–537.

    Article  PubMed  Google Scholar 

  • Christensen, D. L., Baio, J., Van Naarden Braun, K., Bilder, D., Charles, J., Constantino, J. N., Daniels, J., Durkin, M. S., Fitzgerald, R. T., Kurzius-Spencer, M., Lee, L. C., Pettygrove, S., Robinson, C., Schulz, E., Wells, C., Wingate, M. S., Zahorodny, W., & Yeargin-Allsopp, M. (2016). Centers for disease and prevention prevalence and characteristics of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 Sites, United States, 2012. MMWR Surveillance Summaries, 65(3), 1–23.

    Article  PubMed Central  Google Scholar 

  • Fernandez-Jaen, A., Fernandez-Mayoralas, D. M., Calleja-Perez, B., Munoz-Jareno, N., Campos Diaz Mdel, R., & Lopez-Arribas, S. (2013). Efficacy of atomoxetine for the treatment of ADHD symptoms in patients with pervasive developmental disorders: A prospective, open-label study. Journal of Attention Disorders, 17(6), 497–505.

    Article  PubMed  Google Scholar 

  • Greenhill, L., Kollins, S., Abikoff, H., McCracken, J., Riddle, M., Swanson, J., McGough, J., Wigal, S., Wigal, T., Vitiello, B., Skrobala, A., Posner, K., Ghuman, J., Cunningham, C., Davies, M., Chuang, S., & Cooper, T. (2006). Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 45(11), 1284–1293.

    Article  PubMed  Google Scholar 

  • Handen, B. L., Breaux, A. M., Janosky, J., McAuliffe, S., Feldman, H., & Gosling, A. (1992). Effects and noneffects of methylphenidate in children with mental retardation and ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 31(3), 455–461.

    Article  PubMed  Google Scholar 

  • Handen, B. L., Feldman, H., Gosling, A., Breaux, A. M., & McAuliffe, S. (1991). Adverse side effects of methylphenidate among mentally retarded children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 30(2), 241–245.

    Article  PubMed  Google Scholar 

  • Handen, B. L., Johnson, C. R., & Lubetsky, M. (2000). Efficacy of methylphenidate among children with autism and symptoms of attention-deficit hyperactivity disorder. Journal of Autism and Developmental Disorders, 30(3), 245–255.

    Article  PubMed  Google Scholar 

  • Handen, B. L., Sahl, R., & Hardan, A. Y. (2008). Guanfacine in children with autism and/or intellectual disabilities. Journal of Developmental and Behavioral Pediatrics, 29(4), 303–308.

    Article  PubMed  Google Scholar 

  • Harfterkamp, M., van de Loo-Neus, G., Minderaa, R. B., van der Gaag, R. J., Escobar, R., Schacht, A., Pamulapati, S., Buitelaar, J. K., & Hoekstra, P. J. (2012). A randomized double-blind study of atomoxetine versus placebo for attention-deficit/hyperactivity disorder symptoms in children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 51(7), 733–741.

    Article  PubMed  Google Scholar 

  • Harstad, E., Shults, J., Barbaresi, W., Bax, A., Cacia, J., Deavenport-Saman, A., Friedman, S., LaRosa, A., Loe, I. M., Mittal, S., Tulio, S., Vanderbilt, D., & Blum, N. J. (2021). Alpha2-adrenergic agonists or stimulants for preschool-age children with attention-deficit/hyperactivity disorder. JAMA, 325(20), 2067–2075.

    Article  PubMed  Google Scholar 

  • Jou, R. J., Handen, B. L., & Hardan, A. Y. (2005). Retrospective assessment of atomoxetine in children and adolescents with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15(2), 325–330.

    Article  PubMed  Google Scholar 

  • Mahajan, R., Bernal, M. P., Panzer, R., Whitaker, A., Roberts, W., Handen, B., Hardan, A., Anagnostou, E., & Veenstra-VanderWeele, J. (2012). Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders. Pediatrics, 130(Suppl 2), S125-138.

    Article  PubMed  Google Scholar 

  • McCracken, J. T., McGough, J., Shah, B., Cronin, P., Hong, D., Aman, M. G., Arnold, E., Lindsay, R., Nash, P., Hollway, J., McDougle, C. J., Posey, D., Swiezy, N., Kohn, A., Scahill, L., Martin, A., Koenig, K., Volkmar, F., Carroll, D., … Psychopharmacolog, R. U. P. (2002). Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine, 347(5), 314–321.

    Article  PubMed  Google Scholar 

  • Ming, X., Gordon, E., Kang, N., & Wagner, G. C. (2008). Use of clonidine in children with autism spectrum disorders. Brain and Development, 30(7), 454–460.

    Article  PubMed  Google Scholar 

  • Pandina, G. J., Bossie, C. A., Youssef, E., Zhu, Y., & Dunbar, F. (2007). Risperidone improves behavioral symptoms in children with autism in a randomized, double-blind, placebo-controlled trial. Journal of Autism and Developmental Disorders, 37(2), 367–373.

    Article  PubMed  Google Scholar 

  • Posey, D. J., Wiegand, R. E., Wilkerson, J., Maynard, M., Stigler, K. A., & McDougle, C. J. (2006). Open-label atomoxetine for attention-deficit/hyperactivity disorder symptoms associated with high-functioning pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 16(5), 599–610.

    Article  PubMed  Google Scholar 

  • Rast, J. E., Anderson, K. A., Roux, A. M., & Shattuck, P. T. (2021). Medication use in youth with autism and attention-deficit/hyperactivity disorder. Academic Pediatric, 21(2), 272–279.

    Article  Google Scholar 

  • Reichow, B., Volkmar, F. R., & Bloch, M. H. (2013). Systematic review and meta-analysis of pharmacological treatment of the symptoms of attention-deficit/hyperactivity disorder in children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 43(10), 2435–2441.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salazar, F., Baird, G., Chandler, S., Tseng, E., O’Sullivan, T., Howlin, P., Pickles, A., & Simonoff, E. (2015). Co-occurring psychiatric disorders in preschool and elementary school-aged children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2283–2294.

    Article  PubMed  Google Scholar 

  • Scahill, L., J. T. McCracken, B. H. King, C. Rockhill, B. Shah, L. Politte, R. Sanders, M. Minjarez, J. Cowen, J. Mullett, C. Page, D. Ward, Y. Deng, S. Loo, J. Dziura, C. J. McDougle and N. Research Units on Pediatric Psychopharmacology Autism. (2015). Extended-release guanfacine for hyperactivity in children with autism spectrum disorder. American Journal of Psychiatry, 172(12), 1197–1206.

    Article  Google Scholar 

  • Shea, S., Turgay, A., Carroll, A., Schulz, M., Orlik, H., Smith, I., & Dunbar, F. (2004). Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics, 114(5), e634-641.

    Article  PubMed  Google Scholar 

  • Simonoff, E., Taylor, E., Baird, G., Bernard, S., Chadwick, O., Liang, H., Whitwell, S., Riemer, K., Sharma, K., Sharma, S. P., Wood, N., Kelly, J., Golaszewski, A., Kennedy, J., Rodney, L., West, N., Walwyn, R., & Jichi, F. (2013). Randomized controlled double-blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability. Journal of Child Psychology and Psychiatry, 54(5), 527–535.

    Article  PubMed  Google Scholar 

  • Stigler, K. A., Desmond, L. A., Posey, D. J., Wiegand, R. E., & McDougle, C. J. (2004). A naturalistic retrospective analysis of psychostimulants in pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 14(1), 49–56.

    Article  PubMed  Google Scholar 

  • Tarrant, N., Roy, M., Deb, S., Odedra, S., Retzer, A., & Roy, A. (2018). The effectiveness of methylphenidate in the management of attention deficit hyperactivity disorder (ADHD) in people with intellectual disabilities: A systematic review. Research in Developmental Disabilities, 83, 217–232.

    Article  PubMed  Google Scholar 

  • Wigal, T., Greenhill, L., Chuang, S., Mc, G. J., Vitiello, B., Skrobala, A., Swanson, J., Wigal, S., Abikoff, H., Kollins, S., Mc, C. J., Riddle, M., Posner, K., Ghuman, J., Davies, M., Thorp, B., & Stehli, A. (2006). Safety and tolerability of methylphenidate in preschool children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 45(11), 1294–1303.

    Article  PubMed  Google Scholar 

  • Wolraich, M. L., Hagan, J. F., Jr., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & C,. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. https://doi.org/10.1542/peds.2019-2528

    Article  PubMed  Google Scholar 

  • Zeiner, P., Gjevik, E., & Weidle, B. (2011). Response to atomoxetine in boys with high-functioning autism spectrum disorders and attention deficit/hyperactivity disorder. Acta Paediatrica, 100(9), 1258–1261.

    Article  PubMed  Google Scholar 

Download references

Funding

This project is supported by cooperative agreement UA3MC20218 and grant from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Author information

Authors and Affiliations

  1. Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA

    Joanna E. Grater, Elisa I. Muniz, Ellen J. Silver & Ruth E. K. Stein

  2. Perelman School of Medicine, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA

    Nathan J. Blum & Justine Shults

Authors
  1. Joanna E. Grater
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elisa I. Muniz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ellen J. Silver
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nathan J. Blum
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Justine Shults
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ruth E. K. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JEG conceived and presented the idea. ElM, EJS, NJB, JS, and REKS supervised the findings of this work. JS performed statistical analysis. All authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Joanna E. Grater.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grater, J.E., Muniz, E.I., Silver, E.J. et al. Treatment of Attention-Deficit/Hyperactivity Disorder with Medication in Children with Autism Spectrum Disorder With and Without Intellectual Disability: A DBPNet Study. J Autism Dev Disord 53, 3144–3150 (2023). https://doi.org/10.1007/s10803-022-05611-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-022-05611-1

Keywords

Search

Navigation